日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Background: In recent years, greater use of fetal echocardiography has resulted in an increased number of patients diagnosed with fetal congenital heart disease (CHD). Moreover, contextual factors relating to diagnosis are changing in Japan.

Purpose: To summarize a trend in recent fetal echocardiography in our institution and develop ways to improve it.

Methods: We retrospectively studied 687 cases diagnosed with CHD between 2004 and 2013, dividing them into the following two groups: Group A (2004–2008) with 241 cases and Group B (2009–2013) with 446 cases. We retrospectively evaluated various patient factors between the two groups.

Results: The prevalence rate of fetal CHD at our institution was 29.1％ for Group A and 49.0％ for Group B (p＜0.01). The number of CHD cases prenatally diagnosed before 22 gestational weeks significantly increased from 36 cases (14.9％) in Group A to 91 cases (20.4％) in Group B (p＜0.05). Reasons for referral were as follows: suspected CHD, congenital anomaly, and fetal growth restriction with no significant difference between the two groups. The number of non-severe CHD cases significantly increased from 101 cases (41.9％) in Group A to 235 cases (52.7％) in Group B (p＜0.01). There was no significant difference in morbidity between the two groups during the fetal period and after birth.

Conclusion: The number of fetuses diagnosed with CHD increased, particularly those that were less than 22 gestational weeks. Adequate counseling and support should be provided for mothers whose fetus is diagnosed with CHD prior to 22 gestational weeks. In addition, due to the increased number of diagnoses, greater cooperation between delivery hospitals would be beneficial.